Individual provider Active NPI

Suzanne Marie Rettig, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Yakima, WA
National Provider Identifier
1003865437
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL00002833 Issued in WA
Practice address
110 S 9TH Ave
Yakima, WA 98902-3315
Phone
(509) 575-5068
Fax
(509) 577-4604
NPI assigned
May 10, 2006
Last updated
Jan 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X LL00002833 WA Primary

Addresses

Primary practice location

110 S 9TH Ave
Yakima, WA 98902-3315

Mailing address

110 S 9TH Ave
Yakima, WA 98902-3315
Phone (509) 575-5068

Other identifiers 1

IdentifierTypeStateIssuer
7980709MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LL00002833WAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Hearing and Speech Center Speech-Language Pathologist PastSince Mar 27, 1997 Accepting new patients
Yakima Hma Home Health, LLC Past Accepting new patients
Sunnyside Community Hospital Association Past Accepting new patients
Sunnyside Home Health Past Accepting new patients
Brainstorm Rehabilitation, LLC PastSince Aug 18, 2019 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4690/brand/1/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1003865437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S 9TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023315",
            "telephone_number": "509-575-5068",
            "fax_number": "509-577-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S 9TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023315",
            "telephone_number": "509-575-5068",
            "fax_number": "509-577-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETTIG",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "credential": "M.A.  CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00002833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7980709",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.